Medicare and Medicaid appear to be of the largest broken systems in the United States. It is crucial for the two health care systems to sustain themselves in order to provide a more functional care unit for their beneficiaries. Throughout the United States, Medicare is often times seen as the support system for individuals over the age of 65. On the other hand, Medicaid is a program that is administered by the state and provides support for a broader range of people. Each state is individually responsible to administer its own set of guidelines for Medicaid.
Therefore, there are very specific guidelines for judging how much money a certain individual is eligible for. On top of these rules, there are rules for people in nursing home and for
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Medicare covers most people age 65 or older. The next five years proceeding this implementation led to the eligibility covering a broader range of people. To start, Medicare consisted of two very separate parts: Hospital Insurance, also known as Part A, and Supplementary Medical Insurance, which was known as part B. Part A helped pay for inpatient hospital, home health agency, hospice care, sand skill nursing facility. Also, it assisted in providing premiums to most people who were eligible. Conversely, Part B helps pay for physician, outpatient hospital, and other services. This part of health care was only provided to those who paid a monthly premium. The third part of Medicare, also known as Part C, was established in tribute of the Balanced Budget act in 1997. In addition, the Medicare Advantage program seeks to expand beneficiary’ options for participation through the private sector. Lastly the fourth part of Medicare, known as Medicare part D was established in 2006. Part D was seeking to cover any part of prescription drug cost Medicare Part A, B, and C couldn’t. In essence, Part D mainly provided any access to prescription drug discount cards on a very voluntary basis and at a certain cost. When as quoted by United Health, “Medicare began on July 1, 1966, approximately 19 million people enrolled. In 2011, almost 49 million people are enrolled in one or both of Parts A and B of the Medicare program, and over 12 millions of them …show more content…
The reasoning behind implementation was to assist each state in providing a more adequate level of care for people who were eligible and needy. Medicaid was seen as an entitlement program. This program provides medical assistance to families and individuals with low income and resources. Today, Medicaid is the largest program providing medical and health-related services to the considerably poor people of America. Each of the states must, establish its own eligibility standards, determine the type, amount, duration and scope of services, set rates for payment of the services and administrate the program. Each state may vary on each of these guidelines, therefore, a person who is eligible in one state might not be eligible in another State. Although. These guidelines are not perfect, a recent study by HCFA emphasizes on the revisions that are considered, “The need for expanded eligibility and more extensive and enduring services is obvious”. These sorts of expansions are found to be balanced by many Federal
The leadership’s decision not to expand Medicaid leaves between 300,000 and 400,000 South Carolinians without health insurance (South Carolina Medical Association, 2012). The stated intent of the Affordable Care Act, pejoratively dubbed “Obamacare” by its critics, was to put affordable health care within reach of more of the 40 million Americans who lacked health insurance. The law’s grand design included an assumption that states would expand their Medicaid programs, since the federal government would pay 100 percent of the expansion costs through 2016, and 90 percent thereafter. But in demonstrating its traditional mistrust of Washington’s promises, Columbia declined the offer and, in the process, left thousands of low-income workers without the means to obtain health coverage, either because they cannot afford the premiums or because their employers do not provide it. (Advisory Committee, 2013). Ironically, in a state where the median annual income is $44,600, South Carolina’s working poor earn too much money to qualify for Medicaid; however, they would be covered under the ACA model (Hailsmaier and Blasé, 2010).
(II) The enacting of Medicare Part D in 2006 only helped to fuel America’s hunger for prescription medication. In 2003, President George W. Bush announced and signed the Medicare Prescription Drug, Improvement, and Modernization Act (also known as the Medicare Modernization Act, or MMA) on December 8th. The roughly $400 billion dollar measure was marketed to the American public as something that will provide care for the millions of senior citizens who, at the time, were struggling to afford prescription medication. This was the largest development of Medicare since 1965, which is when the program was initially created, and gave hope to those wishing for positive medical reform. According to title XI of the “Medicare Prescription Drug, Improvement, and Modernization Act of 2003”, the most significant change will be the affordability of prescription drugs by implementing the importation of drugs from Canada, along with necessary safety measures, in order to lessen the cost (United States Congress, 832). For those who were in retirement homes and lacked a steady income, the affordability of drugs was often a deciding factor in the decision to seek medical attention and the idea that those individuals ceased to live simply because they lacked the funds tugged at the heartstrings of many Americans.
Medicare is a social policy many of our seniors look to for their stability when they reach 65
Implemented (along with Medicare) as a part of the Social Security Amendments of 1965, Medicaid’s original purpose was to improve the health of the working poor who might otherwise go without medical care for themselves and their families. Medicaid also assisted low income seniors with cautionary provisions that paid for the costs of nursing facility care and other medical expenses such as premiums and copayments that were not covered through Medicare. Eligibility for Medicaid is usually based on the family’s or individual’s income and assets. When the ACA came into effect in 2010, it began to work with the states to develop a plan to better coordinate the two ...
First of all What is Medicare ? Medicare is a federal health insurance both old and young people that needs a cheaper medication and people who are disable. According to Robert Preidt’s Article about medicare he stated that “At least one in four Medicare patients received at least one of these services in 2009, according to the analysis of claims made by more than 1.3 million Medicare patients that year “ his analysis tells us that a bit of americans get their insurance and most of them still pay a lot even though they have insurance provided by the government for example Isadore Cassuto an 88 year old man and a retired tax attorney , broke his pelvis on nov. 12 on a parking lot and spent more than 3 weeks at the rehab hospital . He was stuck with 6,000 bill for his follow up care because of Medicare the federal health plan for people over 65, only pays for inpatient rehabilitation following a serious hospitalization , this analysis is telling us that even an insured retired person who is eligible to pay lesser bill didn't get it instead he payed more . Karen Rowan state...
The author also believes that the Medicaid expansion extends beyond the politics, and has an aim to impact the life, health, and financial stability for the state and individuals. Medicaid expansion can be beneficial to many countries that have a large proportion of low-income people that are uninsured and or with disabilities. This can aid in saving the state money because much of the cost is provided and covered by the federal government, that encourages healthier behavior and results to a reduction in chronic disease due to lower health care costs. Although Texas opted out in adopting the expansion, legislators should decide on the advantage and disadvantage of participating in the Medicaid expansion to improve the welfare of the state. The expansion of Medicaid coverage will give low-income pregnant women the chance to reduce the rate in infant mortality and provide an opportunity for those that were unable to get coverage to be
According to Medicare’s WebPage Medicare is a Health Insurance Program for people 65 years of age and older, some disabled people under 65 years of age, and people with End-Stage Renal Disease (permanent kidney failure treated with dialysis or a transplant). Medicare has two parts, Part A which is for basically hospital insurance. Most people do not have to pay for Part A. In addition it has a Part B, which is basically medical insurance. Most people pay a small monthly fee for Part B. Medicare first went into effect in 1966 and was originally administered by the Social Security Administration. In 1977 the control of it was switched over to the newly formed Health Care Financing Administration. Beginning in July 1973 Medicare was extended to persons under the age of 65 with certain disabling conditions. In 1988 Congress passed legislation to expand the program to cover health care costs of catastrophic illnesses.
Medicare and Medicaid are two of the United States largest broken systems, which must sustain themselves in order to provide care to their beneficiaries. Both Medicare and Medicaid are funding by a joint effort between the federal government and the local state government. If and when these governments choose to cut funding or reduce spending, Medicare and Medicaid take the biggest hit. Most people see these two benefits as one in the same, two benefits the government takes out of their pay check to help fund health care. While the government does deduct a sum from paychecks everywhere, Medicare and Medicaid are very two very different programs.
These facilities are regulated by the state and federal government and these regulations protects the senior residents. For example it is mandatory for the facilities in Texas to provide mandatory services such as daily living activities like dressing, feeding or help prepare meals and cleaning. Depending on the facility license the staff would have to assist with financial management and certain medical services. Even though the federal government developed guidelines the state can make their own as long as it complies with the federal government. Some organizations may accept private pay while others accepted Medicaid. Regulations are developed to protect residence that from being in an unsafe environment. As a result some assisted living and nursing homes are unable to continue services by having fines or closing for an unknown amount of time. Since each state has different set of regulations I will focus on the state regulations in Texas because it is the state I reside in. The organization in Texas that regulates assisted living and nursing homes is the Department of Aging and Disability services(DADS).
The two major components of Medicare, the Hospital Insurance Program (Part A of Medicare) and the supplementary Medical Insurance program (Part B) may be exhausted by the year 2025, another sad fact of the Medicare situation at hand (“Medicare’s Future”). The burden brought about by the unfair dealings of HMO’s is having an adverse affect on the Medicare system. With the incredibly large burden brought about by the large amount of patients that Medicare is handed, it is becoming increasingly difficult to fund the system in the way that is necessary for it to function effectively. Most elderly people over the age of 65 are eligible for Medicare, but for a quite disturbing reason they are not able to reap the benefits of the taxes they have paid. Medicare is a national health plan covering 40 mi...
Medicare and Medicaid are programs that have been developed to assist Americans in attainment of quality health care. Both programs were established in 1965 and are federally supported to provide health care coverage to vulnerable populations such as the elderly, the disabled, and people with low incomes. Both Medicare and Medicaid are federally mandated and determine coverage under each program; both are run by the Centers for Medicare & Medicaid Services, a federal agency ("What is Medicare? What is Medicaid?” 2008).
Medicare and Medicaid are for those who are unable to pay for private health insurance. They were created in 1965 by Lyndon Johnson to meet individual health care needs. Medicare covers those who are 65 or older or who have certain disabilities. It also covers individuals with End-Stage Renal Disease (ESRD) who need dialysis or a kidney transplant. There are four parts of Medicare. They are Part A which covers hospital stays, hospice care, skilled nursing facility care, and home health care. Part B covers doctor services, outpatient care, durable medical equipment, and some preventative services. Part C includes all benefits and services covered under Parts A and B and usually includes Medicare prescription drug coverage (Part D) as part of
Two of the largest government funded insurance groups are Medicare and Medicaid. Between the two, they service upwards of 40% of the total American population(2010 & 2012, KFF). However, the two programs offer various similarities and differences. Medicare is a federal government-sponsored healthcare program primarily for seniors; Medicaid is for low-income families and is managed by both the state and federal governments. By performing a SWOT analysis on each program, it is possible to compare the two.
Medicare and Medicaid are both complex and troublesome programs, dealing with the health of Americans. Both of the agencies were created in 1965. The goal of the agencies is to provide genuine health care to people of all ages in the United States.
With the United Nations listing health care as natural born right and the escalating cost of health care America has reached a debatable crisis. Even if you do have insurance it's a finical strain on most families.